Dr. Todd Sachs of AccessHope: “Active listening”

Active listening. Avoid interrupting. Really listen to what’s being said and what’s not being said. Be inquisitive. Give the person you’re talking to the time, so they can share their experience and what’s going on. If you have determined the course of treatment or plan you’d like to make, it’s important to listen and not […]

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Active listening. Avoid interrupting. Really listen to what’s being said and what’s not being said. Be inquisitive. Give the person you’re talking to the time, so they can share their experience and what’s going on. If you have determined the course of treatment or plan you’d like to make, it’s important to listen and not to disengage or begin documentation. The relationship you develop with patients is critical to their outcome and satisfaction.

One of the consequences of the pandemic is the dramatic growth of Telehealth and Telemedicine. But how can doctors and providers best care for their patients when they are not physically in front of them? What do doctors wish patients knew in order to make sure they are getting the best results even though they are not actually in the office? How can Telehealth approximate and even improve upon the healthcare that traditional doctors’ visits can provide?

In this interview series, called “Telehealth Best Practices; How To Best Care For Your Patients When They Are Not Physically In Front Of You” we are talking to successful Doctors, Dentists, Psychotherapists, Counselors, and other medical and wellness professionals who share lessons and stories from their experience about the best practices in Telehealth. As a part of this series, I had the pleasure of interviewingDr. Todd Sachs.

Dr. Todd Sachs is chief medical officer at AccessHope, a company that provides cancer expertise to employers and their healthcare partners. By delivering a revolutionary employee benefit that connects cancer patients and their families with expertise from National Cancer Institute-designated Comprehensive Cancer Centers, AccessHope is bringing the vast expertise of major medical centers to people near and far.

As chief medical officer, Dr. Sachs helps drive the company’s mission to bridge the cancer knowledge gap in the always-advancing field of cancer research. In his role, he also supports the growth and development of AccessHope’s work nationwide, to help the company — through its services to employers — touch the lives of those facing a cancer diagnosis.

***Disclaimer: While telehealth services have become normalized as a result of the COVID-19 pandemic, AccessHope is not a telehealth provider. Services are best described as remote cancer expert clinical decision support.

Thank you so much for joining us in this interview series! Before we dive in, our readers would love to “get to know you” a bit better. Can you tell us a bit about your ‘backstory’ and how you got started?

My path toward a career in healthcare began while I was a college student studying biochemistry at The University of Wisconsin-Madison. It was there that an unexpected mentor made a huge impact on my trajectory.

I was running an experiment and wanted to check in on it at midnight one Friday. The postdoc saw me and said, “Todd, it’s midnight on a Friday. Why aren’t you out with your friends?” I responded, “I want to make sure the experiment turns out well.”

He appreciated that yet said, “Can I say something without offending you?” and added, “There are different ways to be of help to people — some are behind the scenes, others are in front, and what I see for you, is to be in front of people, helping them directly.” He then asked if I thought about going to medical school, and that question forever changed the course of my career.

I went on to earn my Doctorate of Medicine from Chicago Medical School at Rosalind Franklin University of Medicine and Science. I then progressed through residency and my first postgraduate position was as a staff surgeon in San Francisco.

I also served in various roles during my tenure at Southern California Permanente Medical Group and The Permanente Federation LLC before becoming the Chief Medical Officer at AccessHope in 2020.

Can you share the most interesting story that happened to you since you began your career?

One of the most rewarding moments in my career, when I was a practicing surgeon, was when I helped develop a “community surgery day,” where we offered and provided free surgical care and services to those in need.

Helping people who didn’t have the means to afford medical insurance, we would provide all their surgical needs. One of the patients I took care of had a hernia that was causing pain, and it was increasing in size, and she was unable to hold down a job. I repaired this hernia for her and she was so appreciative that when I saw her for her postoperative visit, tears of joy came down her face as her pain was resolved and she was able to secure a good job. She then held my face with both hands and kissed my cheek with appreciation. I never forgot her or that moment, and felt so privileged to be able to help someone in need and so honored that she trusted me with her health and her life.

Can you please give us your favorite “Life Lesson Quote”? Can you share how that was relevant to you in your life?

One of my favorite quotes is, “My goal in life is to be as good as the person my dog already thinks I am.” I connect to that because of my lifelong love of dogs. I’ve had dogs my entire life. Whether you’ve had a bad day, a good day, whether things are going well or poorly, your dog will love you and be right there by your side. They don’t ask for much, and yet they give so much in return.

None of us are able to achieve success without some help along the way. Is there a particular person who you are grateful towards who helped get you to where you are? Can you share a story about that?

I could certainly list many individuals who have been mentors, and so many people have helped to pave the way for me — but the world of healthcare and medicine is all about relationships and team-building and I’d actually like to identity a team of people rather than a single individual. As a surgeon the team I’d call out includes the anesthesiologist, the circulating nurse, the surgical tech, the assistant surgeon, the pathologist — everyone helping the patient in need and collectively, in a unified effort, providing the best quality of care for the patient. In AccessHope it’s working with a unified, multidisciplinary team of oncology experts to provide members the expertise and knowledge to assist them on their cancer journey, wherever they live.

Ok wonderful. Let’s now shift to the main focus of our interview. The pandemic has changed so many things about the way we behave. One of them of course, is how doctors treat their patients. Many doctors have started treating their patients remotely. Telehealth can of course be very different than working with a patient that is in front of you. This provides great opportunity because it allows more people access to medical professionals, but it can also create unique challenges. To begin, can you articulate for our readers a few of the main benefits of having a patient in front of you?

When you have someone in front of you, there is a natural connection between humans that is so evident and wonderful. In person you can read body language and understand facial expressions far better than in a remote situation. In addition, from a physician’s perspective, you also have the opportunity to do a full physical exam.

That’s changing rapidly because there are now tools that allow you to listen to someone’s heart or lung, or look in their mouth or ear remotely, which is amazing, and I’m sure it will get even better and more refined. But what it lacks is the empathy that happens during a physical exam. I can listen to someone’s lung, but physically being right next to them while I do brings that to a very human level where they have more of a sense of me as a person rather than a cold, removed expert, and I am reminded I’m examining a whole person and not just a lung. You can lose that aspect when providing care remotely.

There are benefits to being remote: greater geographical reach without requiring travel; people are in a more comfortable setting at home; it can feel less scary than being in a physician’s office. But you do lose a little bit of that human touch and connection that can be so beneficial.

On the flip side, can you articulate for our readers a few of the main challenges that arise when a patient is not in the same space as the doctor?

Some of the challenges include not being able to do a comprehensive physical exam, or accurately conduct certain motor skills tests, or do a necessary minor procedure thereby forcing someone to have multiple appointments, for something that normally could be done with one appointment. In my past experience, for example, being able to feel where a patient is having pain — or by examining certain areas, you may, for example, identify lymph nodes that might be enlarged, that can be connected to the physical exam. There also is the human element to in-person visits.

Fantastic. Here is the main question of our interview. Based on your experience, what can one do to address or redress each of those challenges? What are your “5 Things You Need To Know To Best Care For Your Patients When They Are Not Physically In Front Of You? (Please share a story or example for each.)

I have a number of suggestions to help physicians make the most of a virtual healthcare experience. All are important to remember during in-person visits, yet can be even more important in a remote setting. With that said, here are my five tips.

Eye contact (that is culturally sensitive and appropriate). It seems basic in terms of taking care of a person, but eye contact is so important in a virtual setting. You’ll lose opportunities to truly connect with people if you’re not attuned to this; yet remember within some cultures that it is not appropriate, so be prepared before your remote appointment begins.

Active listening. Avoid interrupting. Really listen to what’s being said and what’s not being said. Be inquisitive. Give the person you’re talking to the time, so they can share their experience and what’s going on. If you have determined the course of treatment or plan you’d like to make, it’s important to listen and not to disengage or begin documentation. The relationship you develop with patients is critical to their outcome and satisfaction.

Connect to the person and not their chart. Physicians and medical providers are busy and often multitasking, yet it’s imperative to try and connect with the person in front of you and not be completely absorbed in documenting at that moment.

A holistic experience is helpful. An area I’m so proud of within AccessHope is navigating and supporting members who are on an unwanted journey of cancer, to help them connect and to assist in areas of stress, mental health needs, available community resources, nutrition, support, and warm handoffs with their employers’ benefits programs.

Summarize what you heard. Be appreciative. Thank them for their time and summarize what you heard. This provides comfort to someone to know you heard them and are aligned with them. This is important in an in-person setting as well as remotely.

Can you share a few ways that Telehealth can create opportunities or benefits that traditional in-office visits cannot provide? Can you please share a story or give an example?

By keeping people local, where they live and feel most comfortable, I find that it helps to alleviate people’s anxiety when needing to discuss difficult things.

There’s something comforting about being on “your own turf” versus coming into a physician’s office, that can help patients feel at ease and let down their guard. This in turn allows them to better absorb the information provided which can help them in their care and quality of outcome.

Social determinants of health — primarily, access to healthcare — is a good example of where telehealth can make a big positive impact. Some people don’t have a car or live in remote rural areas with no means to get to a doctor’s appointment, let alone a specialist if needed. This is another area I’m so excited about with AccessHope, because people, wherever they live, can enable their local doctors to receive the most current, up-to-date, and expert medical advice from the top specialists in the country.

Let’s zoom in a bit. Many tools have been developed to help facilitate Telehealth. In your personal experiences which tools have been most effective in helping to replicate the benefits of being together in the same space?

An interesting thing to be aware of is that one size does not fit all, for all people, when it comes to the effectiveness of tools. Video, for example, can be a plus/minus when connecting to a member or patient. For some people, tools like video-based visits are very important because they offer some sort of human connection, but other patients do not like video at all, and feel much freer in their speech and statements when speaking over the phone. So, I find that a multi-channel approach offers more opportunities and choice that people appreciate.

If you could design the perfect Telehealth feature or system to help patients or doctors who are actively using Telehealth, what would it be?

The perfect formula would include ease of use for whomever is participating, by providing the proper processes and allotted time to prevent the patient and the physician or medical provider from feeling rushed. It would also allow for services to be both timely and on-time and offer smooth and easy transitions or handoffs to anyone else that may be needed to help support the individual’s care.

Are there things that you wish patients knew in order to make sure they are getting the best results even though they are not actually in the office?

It’s incumbent upon those of us working in the healthcare system to make sure we’re providing the best advice and options for the patient and not expecting them to lead that aspect of their experience. As healthcare professionals, we should communicate clearly and succinctly what the treatment options are, when a test will be helpful or not, what the latest guidelines and research shows, or if there are new and/or evidence based innovative treatments that may help. What the health care provider looks for, is a patient who is actively involved in this process and wants to be part of a shared decision-making process.

The technology is rapidly evolving and new tools like VR, AR, and Mixed Reality are being developed to help bring people together in a shared virtual space. Is there any technology coming down the pipeline that excites you?

AI is advancing quickly within healthcare and I’m excited as to what this could bring and look at it as an adjunct to the care provided by physicians and/or healthcare providers, but not as their replacement.

My plea however is that as technology evolves, and further assists health care providers and teams, we don’t lose the personal touch of medicine.

Is there a part of this future vision that concerns you? Can you explain?

We have to understand that the world going forward won’t be all-or-nothing when it comes to in-person versus remote delivery of healthcare services. The healthcare world of the future will be a hybrid of some sort, with some percentage of care in person and some percentage of care done remotely. We need to embrace that and not be fearful of it.

Ok wonderful. We are nearly done. Here is our last “meaty” question. You are a person of great influence. If you could inspire a movement that would bring the most amount of good to the most amount of people, what would that be? You never know what your idea can trigger. 🙂

Well thank you for that compliment! In AccessHope, our vision is a world without cancer, and if I can inspire organizations to take a critical look at their strategies and approach to cancer and how they might incorporate solutions like AccessHope, that reach beyond geographies to begin to democratize cancer care, it would be so meaningful.

Until now, the caliber and quality of cancer care has largely been dictated by zip code. According to the American Cancer Society Cancer Facts & Figures 2020 Report, inequalities in socioeconomic status at the individual, neighborhood and regional level are among the leading factors contributing to cancer health disparities in the United States. A recent study by the same organization also estimated that eliminating socioeconomic disparities could prevent 34 percent of cancer deaths among all U.S. adults ages 25 to 74.

In order to eliminate disparities in cancer care — and healthcare in general — that exist across the country, and across the world, we can’t think small. We need to think big! What will really allow us to achieve that is to let expertise — from wherever it’s based — reach people wherever they are. It will take a large movement, not only on a national and federal level, but on a state level, too, and a focus on expanding access to and improving the quality of care as the first and foremost question that’s being answered.

How can our readers further follow your work online?

Visit AccessHope on www.myaccesshope.org and follow us on LinkedIn and Twitter. You can also learn more about the latest cancer knowledge and insights on our blog: https://www.myaccesshope.org/blog.

Thank you so much for the time you spent doing this interview. This was very inspirational, and we wish you continued success.

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